Daphne Bramham: Women and children still dying by the millions

Daphne Bramham, Vancouver Sun columnist09.08.2014

A study has determined that doubling the family planning services in developing nations would only result in a nine-per-cent drop in fertility, but it found fertility rates would drop by 26 per cent if the number of girls completing high school was doubled.

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Nearly seven million children died last year, three million of them died within a month of their birthdays. Another 2.6 million babies were stillborn.

An estimated 289,000 women and girls died during pregnancy or in childbirth because they either received no care or inappropriate care. That’s roughly equal to the combined population of Burnaby and New Westminster.

What’s astonishing is that these horrific global maternal and child mortality statistics are a vast improvement from 25 years ago when the death rates were double that. Still, these improvements fall far short of the United Nations’ millennium development goal of reducing child deaths to four million by 2015 and mothers’ deaths to 130,000.

You’re likely to hear a lot about the issue this week as Prime Minister Stephen Harper hosts a meeting in Toronto to discuss what’s been accomplished and what more needs to be done.

Mostly, what’s needed is money.

If the quality of care received by the richest in the world was universal, there would be 600,000 fewer newborn deaths each year, according to a survey of 51 countries with the highest rate of baby-death rates, published in The Lancet last week.

Babies dying. Children dying. Women dying. It’s all terrible.

But what’s not likely to be on the agenda of Harper’s “Saving Every Woman, Every Child” summit is a discussion of preventing pregnancies and births in the first place.

Population control is almost too controversial to raise these days. Blame China’s one-child policy and India’s equally disastrous population-control programs, which had gender-selected abortions as just one of the unintended consequences. Blame it on domestic politics and the perils of talking about any kind of abortion, let alone gender-selective.

About the only ones willing to talk about it are environmentalists. And even they are likely to do it sotto voce because of fears of provoking public outrage. A few years ago, for example, an Oregon researcher who determined the cost of a child in resource-use terms was called a Nazi.

Yet, population and how people use the Earth’s limited resources is inextricably linked to climate change. Its effects — from worsening droughts, floods, and food scarcity to water and land shortages — are among the biggest global issues we will face in the coming years.

It’s instructive (if not just down right scary) to watch the population increase in real time by clicking on a website like www.worldometers.info/world-population/

This year, the global population has already increased by more 32.5 million; roughly equal to Canada’s entire population. And, unless the population growth rate drops below the current rate of one birth every second, the UN estimates that there will be 9.3 billion people by 2050 — 2.1 billion more than there are now.

But if environmentalists are reluctant to enter the population debate, politicians fear it even more.

Ever since Harper took a leading role in improving global maternal and child health as host of the 2010 G8 meeting, he has been adamant that abortions would not be funded either by Canada or by taxpayer-supported, non-governmental agencies.

The hypocrisy is breathtaking since abortion is legal in Canada as well many of the countries where Canada’s aid money for maternal and child health is directed.

It’s all the more so considering that rape is now widely recognized as a tool of war with the victims, not the perpetrators, having no choice but to live with the consequences if pregnancy results.

This is not an argument for adding abortion to this week’s summit agenda. Imposing abortion is as ridiculous as anti-abortionists imposing child-bearing on unwilling women and girls. And China and India have already proved that imposed policies are no solution to population control.

If women and girls of child-bearing age are ever to be healthy, they need freedom to make their own choices. And that requires far more than even access to contraceptives.

It requires education.

A study by economist and demographer for non-profit human development organization FHI360 Laura Raney and co-author K. Suffarao determined that doubling the family planning services in developing nations would only result in a nine-per-cent drop in fertility, but it found that fertility rates would drop by 26 per cent if the number of girls completing high school was doubled.

Fertility rates dropped by nearly a third for women who had completed secondary school, according to other studies done in Niger and Yemen. Another study showed that girls in developing countries with even seven years’ education marry four years later and have 2.2 fewer children.

Educated women are also more likely to challenge and end customs such as child brides, forced marriages, female genital mutilation, and the so-called justifiable rapes and murders of women and girls.

All of that is happening, but not quickly enough.

The tragedy is that while there always seems to be enough money to wage war, it’s rarely available to fight poverty.

Reducing maternal and child deaths is just a small — but worthy — step toward that.

Yet, even it is too much for many countries; Canada is one of the few developed countries to meet its financial commitment of $2.85 billion to meet the UN’s 2015 target.

And the reality is that access to medical care alone won’t end the needless deaths of babies, children and women.

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